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Brian Muir, PhD
Highly-inquisitive team-leader with 11+ years of experience employing machine learning and statistics in the healthcare industry and in computational biology. Direct the forecasting of $billions in pharmacy and medical expenses using predictive models in R for Centene Corporation’s (Fortune 500) marketplace insurance LOB.
Professional Experience
Director - Marketplace Forecasting
Centene Corporation / Actuarial Services
Chicago, IL
Current - May 2020
Manager - Analytics & Reporting
Centene Corporation / Actuarial Services
Chicago, IL
May 2020 - Jul 2018
- Direct the development, implementation, and presentation of a highly-visible forecast for 7,000+ financial estimates of cost and utilization by month for 27 state health plans and 11 claim categories (e.g. hospital inpatient, primary care, specialty Rx).
- Transformed the medical forecast beyond its essential function as a financial reporting tool by adding member-segmented granularity that pinpoints emerging trends for targeted business actions. Present insights to Centene’s CFO in monthly calls.
- Lead a team of six actuaries and data analysts providing regular guidance and skill training sessions in R.
- Demonstrated ability to build strong collaborations with various technical and non-technical business partners with analytic support and business knowledge across medical, pharmacy, provider, membership, health status, sales, and payment data.
- Proven record of flexibly adapting team workflow to incorporate forecast estimates for direct and indirect COVID costs and various health care policy changes that impacted membership makeup and anticipated costs.
- Developed a member-level gross margin database that combines revenue (e.g premiums, risk transfers) and expense components (e.g. claims) from disparate EDW and financial sources with 40 targetable member, provider, and broker characteristics. Deployed drill-down shiny dashboard in RSConnect that is employed widely across departments to identify opportunities for business initiatives.
- Identified an $8M annual initiative improving on risk adjustment code capture by data-mining pharmacy prior authorization data.
Data Scientist I
Centene Corporation / Business Optimization
Chicago, IL
Jul 2018 - Oct 2017
Data Analyst II
Centene Corporation / Business Optimization
Chicago, IL
Oct 2017 - Sep 2016
- Built and implemented a novel claims completion model using regression to estimate incurred-but-not-reported expenses prior to month end. Model is used for early-warning and to accelerate preparation of financial reporting and commentary.
- Developed a probabilistic outlier-detection model based on episodes of care that is used to highlight targets for quality and cost-saving initiatives.
- Designed enterprise’s primary care auto-assignment algorithm to optimally assign members to local providers identified as high-quality and low-cost.
- Devised interactive RMarkdown reports using automated commentary to highlight emerging trends in Rx utilization; present findings monthly to Pharmacy Directors of local health plans.
Research Experience
Graduate Research Assistant / Computational Biology
University of California Riverside
Riverside, CA
Sep 2010 - Aug 2016
- Analyzed large gene expression datasets with R (Bioconductor) using non-parametric statistical models.
- Performed statistical tests of codon evolution in cancer gene-sequence alignments using maximum likelihood models.
- Designed and directed a multi-year longitudinal experimental evolution study on fruit flies that employed advanced experimental design statistics. Supervised 2 – 6 undergraduate volunteer research assistants per quarter.
- Taught 18 quarters of upper and lower division biology courses with up to 150 students per week. Mentored 2 – 6 undergraduate volunteer research assistants per quarter.
Education
University of California Riverside
Ph.D. in Evolution, Ecology & Organismal Biology
Riverside, CA
2016 - 2010
Boston College
B.S. in Biology, Psychology (Double Major)
Chestnut Hill, MA
2010 - 2006
Publications and Presentations
The expression of tumour suppressors and proto-oncogenes in tissues susceptible to their hereditary cancers.
Muir, B. & Nunney, L. British journal of cancer, 113(2), 345-353.
N/A
2015
Peto’s paradox and the hallmarks of cancer: constructing an evolutionary framework for understanding the incidence of cancer.
Nunney, L. & Muir, B. Phil. Trans. R. Soc. B, 370(1673), 20150161.
N/A
2015
Presentations
International Scientific Conferences
N/A
2014-2015
- International Biannual Evolution and Cancer Conference - Lightning Talk & Poster | 2015
- Evolution Conference - Talk | 2014
Exams & Awards
Exams
Society of Actuaries
N/A
2018-
- PA - Predictive Analytics | Jun 2019
- SRM - Statistics for Risk Modeling | Jan 2019
- P - Probability | Sep 2018
Awards
Research and Education
N/A
2010-2016
- GAANN Fellowship | U.S. Department of Education | 2016
- Outstanding Teaching Assistant | UCR Graduate Division | 2015
- Dissertation Year Fellowship Award | UCR | 2015
- Chancellor’s Distinguished Fellowship Award | UCR | 2010